title: Surgical outcomes after superior vena cava reconstruction with expanded polytetrafluoroethylene grafts.
abstract: OBJECTIVE
  Graft occlusion is a problem after superior vena cava (SVC) reconstruction for thoracic malignancy. Expanded polytetrafluoroethylene (ePTFE) is considered to be an optimal material for venous reconstruction.
  
  
  METHODS
  We reviewed the hospital records of 13 patients who underwent complete resection of thoracic malignancy invading the SVC, including SVC reconstruction with ePTFE grafts. Single bypass grafting was performed in two patients (one right-sided, one left-sided) and double bypasses grafting was performed in the other patients. All patients received antithrombotic therapy after surgery. Eight patients died of recurrence or other disease during the follow-up period (range 5-41 months).
  
  
  RESULTS
  Of the 24 grafts in 13 patients, graft patency was confirmed in 20 grafts in 9 patients at a mean time follow-up time of 47.8 ± 50.0 months after surgery. In the remaining four grafts in four patients, occlusion was diagnosed at a mean time of 1.25 ± 0.50 months after surgery. All obstructed grafts were left-sided bypass grafts in patients who underwent double bypass grafting, and did not result in SVC syndrome.
  
  
  CONCLUSIONS
  SVC reconstruction with ringed ePTFE grafts was safe and had good outcomes. In patients who underwent double bypasses grafting, the left-sided bypass grafts were susceptible to occlusion.
authors.affiliation: Department of General Thoracic Surgery, Jichi Medical University Saitama Medical Center, Omiya, Saitama, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakano
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Endo
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kanai
authors.forename: Shinichi
authors.initials: S
authors.lastname: Otani
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Tsubochi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Tetsuka
mesh_terms: D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D013899:Thoracic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014683:Vena Cava, Superior / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D011138:Polytetrafluoroethylene